Methods and systems for interleaving waveforms for electrical stimulation and measurement

Abstract

A system can utilize interleaving periods or waveforms to stimulate patient tissue and sense signals using the stimulation electrodes. For example, the system can utilize alternating therapeutic periods and sensing periods. As another example, the system can alternate between biphasic waveforms having opposite temporal orders of positive and negative phases. As another example, waveforms that differ in a parameter, such as amplitude or pulse width, can be interleaved to provide different information in the respective sensed signals.

What is claimed as new and desired to be protected by letters patent of the united states is: 
     
         1 . An electrical stimulation system, comprising:
 at least one electrical stimulation lead, each of the at least one electrical stimulation lead comprising a plurality of stimulation electrodes; and   a processor coupled to the lead and configured to perform actions, comprising: 
 a) directing delivery of a first waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of a patient; 
 b) directing sensing of a first electrical signal from the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the first waveform; 
 c) after directing delivery of the first waveform, directing delivery of a second waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of the patient, wherein the first waveform differs from the second waveform in amplitude, pulse shape, pulse width, pulse period, electrode selection, or electrode fractionalization; 
 d) directing sensing of a second electrical signal from the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the second waveform; and 
 e) using the first and second electrical signals to adjust at least one of the first waveform or the second waveform. 
   
     
     
         2 . The electrical stimulation system of  claim 1 , wherein the first and second waveforms are therapeutic waveforms. 
     
     
         3 . The electrical stimulation system of  claim 1 , wherein the first electrical signal comprises an electrospinogram signal or an electrical filed potential. 
     
     
         4 . The electrical stimulation system of  claim 1 , wherein directing sensing of the first electrical signal comprises directing sensing of the first electrical signal from the tissue using at least two of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the first waveform. 
     
     
         5 . The electrical stimulation system of  claim 1 , wherein using the first and second electrical signals comprises analyzing the first and second electrical signals to extract features or recognize patterns in at least one of the first or second electrical signals. 
     
     
         6 . The electrical stimulation system of  claim 1 , wherein using the first and second electrical signals comprises analyzing the first and second electrical signals to produce information about at least one neural response, heartbeat signals, respiration, patient activity, or patient posture. 
     
     
         7 . The electrical stimulation system of  claim 1 , wherein the actions further comprise
 after directing delivery of the first and second waveforms, directing delivery of a third waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of the patient, wherein the third waveform differs from the first and second waveforms in amplitude or pulse width; and   directing sensing of a third electrical signal from the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the third waveform.   
     
     
         8 . The electrical stimulation system of  claim 1 , wherein the first and second waveforms are biphasic waveforms with a positive phase and a negative phase. 
     
     
         9 . The electrical stimulation system of  claim 8 , wherein the actions further comprise repeating steps a) to d) except reversing a temporal order of the positive phase and negative phase of the first and second waveforms. 
     
     
         10 . A method for electrical stimulation, the method comprising:
 a) directing delivery of a first waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of a patient;   b) directing sensing of a first electrical signal from the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the first waveform;   c) after directing delivery of the first waveform, directing delivery of a second waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of the patient, wherein the first waveform differs from the second waveform in amplitude, pulse shape, pulse width, pulse period, electrode selection, or electrode fractionalization;   d) directing sensing of a second electrical signal from the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the second waveform; and   e) using the first and second electrical signals to adjust at least one of the first waveform or the second waveform.   
     
     
         11 . The method of  claim 10 , wherein using the first and second electrical signals comprises analyzing the first and second electrical signals to extract features or recognize patterns in at least one of the first or second electrical signals. 
     
     
         12 . The method of  claim 10 , wherein using the first and second electrical signals comprises analyzing the first and second electrical signals to produce information about at least one neural response, heartbeat signals, respiration, patient activity, or patient posture. 
     
     
         13 . The method of  claim 10 , wherein the actions further comprise 
 after directing delivery of the first and second waveforms, directing delivery of a third waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of the patient, wherein the third waveform differs from the first and second waveforms in amplitude or pulse width; and   directing sensing of a third electrical signal from the tissue using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the third waveform.   
     
     
         14 . The method of  claim 10 , wherein the first and second waveforms are biphasic waveforms with a positive phase and a negative phase, wherein the method further comprises repeating steps a) to d) except reversing a temporal order of the positive phase and negative phase of the first and second waveforms. 
     
     
         15 . An electrical stimulation system, comprising:
 at least one electrical stimulation lead, each of the at least one electrical stimulation lead comprising a plurality of stimulation electrodes; and   a processor coupled to the lead and configured to perform actions, comprising: 
 directing delivery of a first biphasic waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of a patient, wherein the first biphasic waveform comprises a first phase and a second phase which occurs after the first phase and is opposite in polarity to the first phase; 
 directing sensing of a first electrical signal using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the first biphasic waveform; 
 after directing delivery of the first biphasic waveform, directing delivery of a second biphasic waveform through at least one of the stimulation electrodes of the at least one electrical stimulation lead to tissue of the patient, wherein the second biphasic waveform comprises a third phase and a fourth phase which occurs after the third phase, wherein the third phase is opposite in polarity to both the first phase and the fourth phase; 
 directing sensing of a second electrical signal using at least one of the stimulation electrodes of the at least one electrical stimulation lead after delivery of the second biphasic waveform; and 
 combining the first and second electrical signals to reduce at least one artifact arising in the sensing of the first and second electrical signals. 
   
     
     
         16 . The electrical stimulation system of  claim 15 , wherein the first and second biphasic waveforms are therapeutic waveforms. 
     
     
         17 . The electrical stimulation system of  claim 15 , wherein the first biphasic waveform is asymmetric. 
     
     
         18 . The electrical stimulation system of  claim 15 , wherein the first and second biphasic waveforms are the same except for temporal phase ordering. 
     
     
         19 . The electrical stimulation system of  claim 15 , the actions further comprise scaling at least one of the first and second electrical signals prior to combining the first and second electrical signals. 
     
     
         20 . The electrical stimulation system of  claim 15 , wherein combining the first and second electrical signals comprises adding or averaging the first and second electrical signals.